Individual
ANTHONY KALEEL DYSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
011750957
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
868966348
UNITEDHEALTHCARE
LA
Enumeration date
05/28/2019
Last updated
05/28/2019
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